文章摘要
复合丙泊酚时阿芬太尼抑制胃镜置入反应的半数有效剂量
Median effective dose of alfentanil blunting responses to gastroscopy when combined with propofol
  
DOI：10.12089/jca.2022.08.002
中文关键词: 阿芬太尼  丙泊酚  胃镜  半数有效剂量
英文关键词: Alfentanil  Propofol  Gastroscopy  Median effective dose
基金项目:南京市医学科技发展资金资助（QRX17019，YKK18105）；江苏省六大人才高峰项目（WSW-106）
作者单位E-mail
蒋婷婷 210006,南京医科大学附属南京医院（南京市第一医院）麻醉科  
刘月 210006,南京医科大学附属南京医院（南京市第一医院）麻醉科  
徐漫 210006,南京医科大学附属南京医院（南京市第一医院）麻醉科  
谭其莲 210006,南京医科大学附属南京医院（南京市第一医院）麻醉科  
蒋宇智 210006,南京医科大学附属南京医院（南京市第一医院）麻醉科  
孙蓓 210006,南京医科大学附属南京医院（南京市第一医院）麻醉科  
赵雅梅 210006,南京医科大学附属南京医院（南京市第一医院）麻醉科  
斯妍娜 210006,南京医科大学附属南京医院（南京市第一医院）麻醉科 siyanna@njmu.edu.cn 
摘要点击次数: 1385
全文下载次数: 630
中文摘要:
      
目的 探讨复合丙泊酚时阿芬太尼抑制胃镜置入反应的半数有效剂量（ED50）。
方法 选择择期行胃镜检查患者23例，男11例，女12例，年龄18～64岁，BMI 18～24 kg/m2，ASA Ⅰ或Ⅱ级。麻醉诱导时静脉注射阿芬太尼（30 s内推注完毕），随后给予丙泊酚血浆靶控输注，靶控浓度为3 μg/ml，待改良警觉镇静评分（MOAA/S）评分为0分时置入胃镜。依据Dixon序贯法确定阿芬太尼剂量（初始剂量为4.5 μg/kg），如出现胃镜置入阳性反应，则下一位患者增加剂量至高一级，否则降低剂量至低一级，剂量梯度为0.5 μg/kg。胃镜置入阳性反应标准：胃镜置入时或1 min内患者出现呛咳、恶心和（或）发生体动反应。研究过程中出现7次折返则停止试验。计算复合丙泊酚时阿芬太尼抑制胃镜置入反应的ED50、95%有效剂量（ED95）及95%可信区间（CI）。
结果 复合丙泊酚时单次静脉推注阿芬太尼抑制胃镜检查患者置入反应的ED50为4.70 μg/kg（95%CI 3.92～5.79 μg/kg），ED95为5.87 μg/kg（95%CI 5.23～16.94 μg/kg）。
结论 复合丙泊酚时阿芬太尼抑制胃镜检查患者置入反应的ED50为4.70 μg/kg。
英文摘要:
      
Objective To determine the median effective dose (ED50) of alfentanil inhibiting responses to gastroscopy combined with propofol infusion.
Methods Twenty-three patients undergoing gastroscopy, 11 males and 12 females, aged 18-64 years, BMI 18-24 kg/m2, ASA physical status Ⅰ or Ⅱ, were enrolled. Patients received intravenous infusion of alfentanil within 30 seconds, and subsequently received propofol plasma target-controlled infusion with a target concentration of 3 μg/ml. Gastroscopy was performed when the level of modified observer's assessment of alertness and sedation (MOAA/S) was 0. The dose of alfentanil was determined using modified Dixon's up-and-down sequential method, and the initial dose was 4.5 μg/kg. When the insertion response was positive, the concentration of alfentanil increased by 0.5 μg/kg in the next patient. Otherwise, the concentration decreased by 0.5 μg/kg in the next patient. The insertion response of gastroscopy was defined as choking cough, nausea, and/or body movement when inserting the gastroscopy into pharyngeal cavity or within 1 minute. The test was completed after 7 independent cross-over pairs were observed. The ED50, 95% effective does (ED95) and 95% confidence interval (CI) of alfentanil inhibiting responses to gastroscopy were calculated.
Results When intravenous infusion combined with propofol, the ED50 of alfentanil inhibiting responses to gastroscopy insertion was 4.70 μg/kg (95% CI 3.92-5.79 μg/kg), and the ED95 was 5.87 μg/kg (95% CI 5.23-16.94 μg/kg).
Conclusion The ED50 of alfentanil inhibiting responses to gastroscopic insertion was 4.70 μg/kg when intravenously infused combined with propofol.
查看全文   查看/发表评论  下载PDF阅读器
关闭